How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4.90 Median $6.46 Typical High $7.24 | Facility | None | $4.90 | $6.46 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
BCBS Arizona Setting Facility Modifier None Typical Low $1.62 Median $5.50 Typical High $18.20 | Facility | None | $1.62 | $5.50 | $18.20 |
BCBS Arizona Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $22.91 | Professional | None | $3.24 | $3.24 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $4.37 Median $6.17 Typical High $6.61 | Facility | None | $4.37 | $6.17 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Medica Setting Facility Modifier None Typical Low $2.88 Median $4.68 Typical High $6.17 | Facility | None | $2.88 | $4.68 | $6.17 |
Medica Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 52 · Reduced service | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | 53 · Discontinued | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | 55 · Aftercare only | $0.59 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.39 | $0.39 | $0.39 |
Where Arizona sits
The same service costs 4.0 times more in Oklahoma than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Arizona· 14th of 51
$4.07
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.